Dissociated Identity Disorder (DID) is one of the most challenging disorders to manage. DID is a fascinating disorder as the patient must present at least two personalities with unique patterns of perception. The personalities must also influence the patient's behavior. Professionals and researchers disagree on the diagnosis and treatment of DID. But most researchers agree that childhood trauma is a significant risk factor for DID. The paper is an annotated bibliography on DID, particularly on the theme of childhood trauma as the main cause of DID.
Jacobson, L., Fox, J., Bell, H., Zeligman, M., & Graham, J. (2015). Survivors with Dissociative Identity Disorder: Perspectives on the counseling process. Journal of Mental Health Counseling, 37 (4), 308-322.
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The article examines the effects of counseling and treatment outcomes on patients diagnosed with DID. According to the authors, many researchers explore the history of childhood trauma in DID patients, but they feel to consider if DID patients will improve once they begin seeking treatment for DID and the underlying issues. The researchers used purposive sampling to identify 13 participants for the study. The goal of the study was to determine effective and ineffective counseling techniques and their effects on patients with DID.
The study identified effective therapy approaches, relationship-building techniques, as well as ineffective approaches. Some of the effective approaches include coping skills, hypnotherapy and support group. The research concludes by urging therapists to adopt effective strategies to address trauma and reduce the symptoms of DID. The article is added to the theme of childhood trauma as a cause of DID; it states that when childhood trauma is not managed, it leads to DID; therefore, therapists should adopt effective measures to help patients manage trauma better.
Vissia, E. M., Giesen, M. E., Chalavi, S., Nijenhuis, E. R., Draijer, N., Brand, B. L., & Reinders, A. A. (2016). Is it Trauma ‐ or Fantasy ‐ based? Comparing dissociative identity disorder, post ‐ traumatic stress disorder, simulators, and controls . Acta Psychiatrica Scandinavica, 134( 2), 111-128.
In the article, the authors attempt to reconcile the Trauma model of DID and the Fantasy Model. The trauma model states that physical and sexual abuse, as well as chronic neglect in one’s childhood, is a cause of DID. On the contrary, the Fantasy Model states that high suggestibility causes DID. The study included 55 participants with DID, PTSD, and the healthy control group. The study found out that the DID group was not fantasy-prone. They DID group did not generate false memories, hence the conclusion that Trauma Model explains the cause of DID more than the Fantasy Model.
The article compares the two models of DID. Researchers have failed to agree on the causes of DID, and this study showed that the trauma model is a potent model. The article supports the theme of the article that childhood trauma is the primary cause of DID. However, the authors used a small sample in the study since the study combined patients with DID and post-traumatic stress disorder; hence the results might not be reliable.
Bell, H., Jacobson, L., Zeligman, M., Fox, J., & Hundley, G. (2015). The role of religious coping and resilience in individuals with dissociative identity disorder. Counseling and Values, 60 (2), 151-163.
The authors link trauma, resilience and spiritual coping in individuals with DID. The goal of the paper is to explore the issue of religious coping in patients with the history of DID. The negative impact of childhood trauma can make an individual resort to religion to deal with the negative emotions. The researchers recruited 53 participants to take part in the study. The participants took part in an online survey focusing on how they manage DID and the role of religion in their lives. The study found out that patients with DID use positive and negative religious beliefs to cope with DID. The patients were dealing with serious childhood abuse issues, and religious coping helped them to manage their conditions.
The article contributes to the theme of the paper. It shows that DID patients are so traumatized such that they rely on religious coping to manage their condition. The article also reported that negative and positive religious beliefs help DID patients. The authors add that religion can be a source of trauma, some religious beliefs and rituals can be traumatizing.
Maiese, M. (2016). Dissociative identity disorder and ambivalence. Philosophical Explorations, 19 (3), 223-237.
Maise (2016) attempts to explain DID by refuting how DID is popular understood. The goal of the article is to change the widespread perception of DID. According to the article, DID involves a single self suffering from significant disruptions to self-consciousness. Some of the symptoms of DID include evidence of overlapping abilities and memory and dissociation, which shows that internal conflict endured by an individual causes DID.
The researcher challenges popular explanations of DID such as the multiple self theses and the Frankfurt-style account of emotional ambivalence. For example, the multiple self-theses (MST) often assume that the two personalities are distinct yet they overlap. There is no clear way of differentiating the two personalities, hence DID should be described as a disruption to self-consciousness.
The article adds to theme of the paper. While Maise challenges the popular perception of DID, she acknowledges that childhood abuse and trauma are common risk factors for DID. Children are more prone to dissociation and creating imaginary friends, especially when they are dealing with issues beyond their control such as abuse and neglect.
Hart, C. (2013). Held in mind, out of awareness. Perspectives on the continuum of dissociated experience, culminating in dissociative identity disorder in children . Journal of Child Psychotherapy, 39 (3), 303-318.
The article by Hart (2013) describes how trauma is processed by the human brain to give an aetiology of DID. According to Hart, traumatic experiences trigger heightened levels of emotional arousal which is stored in the procedural memory systems. The elevated emotional arousal makes the hippocampus to evaluate sensory information wrongly. Since the hippocampus is responsible for organizing and integrating information based on time, place and context; it can generate a wrong narrative due to stress hormones caused by trauma.
The author uses four clinical cases of patients switching between different states. In the four cases, the patients have the history of abuse and neglect. This article suggests that patients with traumatic pasts are likely to experience DID. The article also gives a scientific explanation of DID by claiming that the brains of DID patients operate differently due to the history of abuse. Abuse and neglect represent heightened emotional arousal which affects how the hippocampus organizes information.
Brand, B. L., Loewenstein, R. J., & Spiegel, D. (2014). Dispelling myths about dissociative identity disorder treatment: An empirically based approach . Psychiatry: Interpersonal and Biological Processes, 77 (2), 169-189.
The goal of the article is to examine whether the treatment of DID is harmful or not. Many studies claim that psychotherapy for DID is harmful, while an equal number of studies argue that it is beneficial. The authors review articles on DID published in English since 1989 from PsychINFO ad PubMed databases. The authors analyze the findings of hundreds of studies to conclude that phasic treatment of DID done by experts improves DID. DID patients receiving treatment report improved functioning, reduced hospitalization, and cost of treatment. The article also adds that poor outcome of DID treatment occurs when the treatment fails to engage the two states to repair identity fragmentation.
As much as the primary focus of the article is the treatment of DID, it also touches on trauma as the primary cause of DID. The article reviews hundreds of research studies on DID claiming that carefully staged trauma-focused psychotherapy can improve outcomes. Treatment of DID requires an understanding of the underlying trauma and dealing with the trauma efficiently so that DID patients can have better control.
References
Bell, H., Jacobson, L., Zeligman, M., Fox, J., & Hundley, G. (2015). The role of religious coping and resilience in individuals with dissociative identity disorder. Counseling and Values , 60 (2), 151-163.
Brand, B. L., Loewenstein, R. J., & Spiegel, D. (2014). Dispelling myths about dissociative identity disorder treatment: An empirically based approach. Psychiatry: Interpersonal and Biological Processes , 77 (2), 169-189.
Hart, C. (2013). Held in mind, out of awareness. Perspectives on the continuum of dissociated experience, culminating in dissociative identity disorder in children. Journal of Child Psychotherapy , 39 (3), 303-318.
Jacobson, L., Fox, J., Bell, H., Zeligman, M., & Graham, J. (2015). Survivors with Dissociative Identity Disorder: Perspectives on the counseling process. Journal of Mental Health Counseling , 37 (4), 308-322.
Maiese, M. (2016). Dissociative identity disorder and ambivalence. Philosophical Explorations , 19 (3), 223-237.
Vissia, E. M., Giesen, M. E., Chalavi, S., Nijenhuis, E. R., Draijer, N., Brand, B. L., & Reinders, A. A. (2016). Is it Trauma ‐ or Fantasy ‐ based? Comparing dissociative identity disorder, post ‐ traumatic stress disorder, simulators, and controls. Acta Psychiatrica Scandinavica , 134 (2), 111-128.
